Discomfort in the Rib Area
A 35-year-old woman, who is 5 feet tall, lives with type 1 diabetes and is on several medications including Pristiq, Caplyta, Repatha, Humulin, Atorvastatin, Warfarin, Mirtazapine, and an over-the-counter multivitamin. For the past 15 and a half years, starting from my pregnancy, I have been experiencing intermittent sensations that I refer to as "rib pains." These discomforts begin in my back and extend around to the region beneath my breasts. At times, the ache can spread to encompass the entire upper torso and reach the tops of my shoulders. The pain can be quite intense and, once it subsides—often resembling a spasm—I find myself utterly drained and in need of a nap. A couple of years back, I consulted with a surgeon regarding the potential removal of my appendix, which ultimately did not take place due to the unexpected resolution of a fecolith. During that appointment, however, the surgeon attributed my discomfort to my liver. He noted that it is enlarged and can be felt pushing out beneath my ribs. Following various tests, I was diagnosed with Non-Alcoholic Fatty Liver Disease (NAFLD). I have a few questions for the community: Could my rib pain genuinely stem from my liver condition? What could be the reason for my severe fatigue following these episodes? Additionally, I've noticed that consuming something extremely cold sometimes alleviates the pain—is there a connection?
Answers (1)
2/15/2026, 9:10:40 AM
OpenHealth AI
Main Points: Your rib discomfort could be linked to your liver condition (NAFLD) and potentially other factors. The fatigue you're experiencing after pain episodes, and the relief from cold stimuli, are noteworthy. It's important to understand these symptoms and consider actionable steps for relief.
Explanation:
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Liver Connection: Your description of rib pain, especially with an enlarged liver diagnosed with NAFLD, suggests that your liver could be a source of discomfort. When the liver enlarges, it can stretch the surrounding tissues or push against adjacent organs, causing pain in the right upper abdomen or under the ribs. This is not unusual in individuals with liver changes.
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Fatigue: The severe fatigue following pain episodes might stem from several factors, including:
- Energy Expenditure: Pain often triggers a stress response in the body, leading to fatigue.
- Quality of Sleep: If you are disturbed while managing pain, this can impact your overall rest and energy levels.
- Medication Effects: Some medications can cause fatigue as well, especially those affecting the central nervous system.
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Cold Relief: The relief from consuming something cold may be due to its numbing effect on the area or its potential to reduce spasm by relaxing the muscles temporarily. It's a common response to seek cooling sensations during painful episodes.
Next Steps:
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Monitor Symptoms:
- Keep a detailed diary of your symptoms, noting when episodes occur, their intensity, duration, and any triggers (e.g., stress, specific foods).
- Record your fatigue levels following these episodes.
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Self-Care Strategies:
- Positioning: Try different positions that might alleviate pressure on your abdomen and back. Gentle stretches or using a heating pad on your back may help ease the discomfort.
- Diet: Consider a balanced diet that supports liver health (like low-fat, high-fiber foods) and avoid excessive carbohydrates or sugars, as managing diabetes and NAFLD is crucial.
- Hydration: Stay well-hydrated to support overall health and potentially alleviate discomfort.
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Engage with Your Care Team:
- It would be beneficial to discuss your symptoms with your healthcare team, particularly regarding your liver condition and potential adjustments in your management plan, including a review of your medications to check for side effects.
Understanding the connections between your symptoms and your health conditions can help you manage them effectively. Don’t hesitate to reach out for further support or clarification on your symptoms and concerns.
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